The Correlation between quantity of restricted parenteral antimicrobial use and susceptibility of drug-resistant bacteria in Inpatient department, kantharalak hospital

Abstract

This descriptive research aimed to study the quantity and trend of restricted parenteral antimicrobial prescribing and to study the relationship between quantity of restricted parenteral antimicrobial use and susceptibility of drug-resistant bacteria. This was a retrospective study that collected the data of six antibiotics with prescribing controls and antimicrobial susceptibility report of 8 microorganisms from the electronic database of Kantharalak Hospital during the year 2019-2022. The amount of antimicrobial use was calculated as DDD/100 patient-days. The trends of antimicrobial consumption and the relationship between antimicrobial consumption and antimicrobial susceptibility were assessed using descriptive statistics. The overall result of antimicrobial consumption tends to decrease. Meropenam was the highest antimicrobial consumption followed by Piperacillin/tazobactam and Colistin that were 11.44, 6.66 and 2.02 DDD/1000 bed days, respectively. Piperacillin/tazobactam Imipenem/cilastatin and Cefoperazone/sulbactam had increased consumption rate yearly meanwhile Meropenem Vancomycin, and Colistin had decreased consumption rate yearly. In the year 2022, there was a downward trend in almost all antimicrobial drugs except Imipenem/cilastatin. The trend of antimicrobial consumption showing an opposite trend in antimicrobial susceptibility include piperacillin/tazobactam with a higher tendency use but the susceptibility of P. aeruginosa (MDR), K. pneumoniae (ESBL), and E. coli (ESBL) to piperacillin/tazobactam tended to decrease. The same applies to Imipenem and Cefoperazone/sulbactam with a higher tendency use but the susceptibility of A. baumannii (MDR), P. aeruginosa (MDR), and E. coli (ESBL) to this antimicrobial agents tended to decrease. The relationship of restricted parenteral antimicrobial use and susceptibility of drug-resistant bacteria tended to be inverse meaning that the amount of antibiotic use is increasing but the microorganisms are less susceptible to antimicrobial agents. Therefore, the antimicrobial stewardship is needed the cooperation of relevant multidisciplinary teams for support rational drug use and reduce the problem of drug-resistant bacteria in the hospital.